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Monday, June 20, 2011

in retrospect

Today I ate lunch with one of my friends, a cardiovascular tech who does the EKG and hemodynamic monitoring in the cath lab. Actually, she was the one person who took the time to teach me a lot about reading EKGs and how to use Holter monitoring software to make reports.

I don't remember how we got started on it, but I started rambling about some of the "cool stuff" that I had the chance to see in real time when I worked in the ICU: torsades de pointes, other ventricular tachycardias, ventricular fibrillation and other lethal arrhythmias that you hope you won't be encountering when you're reading outpatient Holter monitor recordings 48+ hours after you stuck your electrodes to your patient.

I paused for a minute, thinking about the last episode of torsades.

"The guy was actually dying," I told her. He was really sick: on a ventilator for weeks and weeks, feverish in septic shock (from a strain of VRE that seemed to take forever to find, after endless blood culture draws and procedures ending in -centesis). He was completely unresponsive by that point, and he was alone.

I remember sitting outside his room, looking at the monitor, watching in awe as the amplitude on his EKG twisted like crepe-paper party streamers. I had seen it books, but never in real life. He was a DNR, and so we sat there still, leaving the crash carts tucked against the nursing pods, as the torsades turned to coarse vfib that slowly grew finer until it was just a haphazard line.

I don't know why I didn't go in there and hold his hand, or even just sit with him. I don't know why any of us didn't. The idea of dying in the middle of the night, in a hospital bed, alone, just doesn't seem okay. Maybe we were feeling mildly inconvenienced by the idea of having to gown up to go into his contact precautions room or divert our eyes from the monitor or documentation. I don't even remember what I was thinking while I sat there doing nothing. Hopefully something besides "wow, cool EKG!"

I wonder, had death started to become so familiar that it had lost its significance? I really don't know. After he died, I cut up his strips, somewhat somberly affixed them to pages and pages of strip sheets, labeled them, and thought about how sad they were -- how they told a story all by themselves.

About Me

I'm 26, a mother, and debating what to do next! As an undergrad at Oberlin I studied what I loved: classical singing. My fascination with the physiology behind singing and the natural intelligence of the human body fueled my growing interest in medicine. Convinced I wanted to go to medical school, I applied for post-bac pre-med programs, got in a couple times, and ended up not going a couple times! Now I'm developing medical software at the hospital where I work and taking a step back. This blog is about my work, educational and personal experiences (and disasters) in healthcare.

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Contact Me

elspeth.greene@gmail.com

Quoted

"Understanding is a kind of ecstacy."

-Carl Sagan, Broca's Brain

"The only people for me are the mad ones, the ones who are mad to live, mad to talk, mad to be saved, desirous of everything at the same time, the ones who never yawn or say a commplace thing, but burn, burn, burn, like fabulous yellow roman candles exploding like spiders across the stars..."

-Jack Kerouac, On the Road

Disclaimer

In case it isn't obvious, this blog not medical advice. All stories involving patients have been grossly altered to protect patient confidentiality. Autobiographical posts have not been altered (with the exception of names).

before I die

I want to learn to fiddle, try Bikram yoga, sing in a band, run a marathon, brew beer, get into medical school, grow romanesco, become a physician, publish something, kayak on our lake, plant an orchard, start performing classically again, drive a manual truck, learn to play the mandolin, make sturm, take a neuropharmacology class, and procure my own firewood by being badass with a chainsaw.